I frequently encounter dental patients who are displeased with the color and appearance of their teeth. One of the most common questions new patients ask me is how they can whiten their smile. Unfortunately, there is a great deal of confusion and misinformation swirling around this subject. What are some of the common misconceptions and what is the truth about tooth whitening?
Myth #1: Tooth whitening doesn’t work.
Actually, tooth whitening is very effective for the vast majority of patients. Most patients can lighten their teeth 2-3 shades or more with the right product and technique. How teeth are bleached is important, and if done incorrectly, the results are disappointing. It is difficult for the average consumer to sort through the marketing of whitening toothpastes, mouth rinses, strips, trays, at-home professional products, and in-office bleaching services. The truth is, that each patient is unique and deserves a customized plan that will increase their chance for success.
Myth #2: I can just use whitening toothpaste or mouth rinse to whiten.
Most patients will find these products to be ineffective for this purpose. Whitening toothpastes typically have more abrasives and detergents to help with whitening. These are used to polish stains off the outside of the teeth and are minimally effective for non-tobacco users.
Unfortunately, more abrasives increase the chance of harm to any exposed root surfaces below the white crown of the tooth. Even if there are bleaching agents in the toothpaste, they are minimally effective at changing the tooth shade due to low concentration and minimal contact time with the teeth. Whitening rinses often have a bleaching ingredient, but may take up to 3 months to whiten the teeth 1-2 shades. The bottom line for effectiveness is adequate bleach concentration and contact time with the teeth.
Myth #3: In-office bleaching is more effective than at-home treatments.
In-office bleaching can make a dramatic difference in tooth appearance in one day, but the rebound back to previous shades is also much faster. To combat this, I recommend either at-home bleaching for two to three weeks or an in-office treatment followed by at-home bleaching. The results of these options have been shown to be the same, so in-office bleaching makes the most sense if there is a wedding or photo shoot coming up quickly. Several years ago, it was popular to activate in-office bleaching with a light or laser. This can increase the speed of whitening, but may also increase tooth sensitivity.
Myth #4: Whitening my teeth will hurt.
Thanks to modern chemistry and desensitizers, most patients can comfortably complete a series of tooth whitening with minimal to no discomfort. A professionally fitted tray and proper technique limit the spread of the bleach (usually carbamide peroxide or hydrogen peroxide) to the desired areas. This allows even patients who have historically experienced sensitivity to bleaching to complete a successful course of treatment.
Myth #5: Professional bleaching is too expensive.
For as little as the cost of two to three family meals at a restaurant, you could have professionally-fitted, custom trays with the necessary bleaching product. In addition, you’ll benefit from a dentist evaluating your teeth and your unique situation throughout treatment.
Myth #6: All teeth bleach the same.
As you may be aware, not all teeth respond the same to whitening treatment. Some dental stains are internal (intrinsic) and some are external (extrinsic). Intrinsic stains are due to genetics, age, antibiotic use, excessive fluoride, root canals, silver fillings, and trauma. On the other hand, external stains are usually caused by pigmented foods, tobacco, and metals like iron and copper. External stains are most amenable to bleaching, although some internal stains can be bleached with longer treatment times. Finally, dental restorations like fillings, crowns, and veneers do not bleach. Even if you have some dental restorations on visible areas of your teeth, you may still be able to whiten your smile. I recommend you talk with your dentist about your options. He or she may not even be aware that you’d really like a whiter smile and would love to help you get the look you’re dreaming of.
Myth #7: Tooth whitening doesn’t last.
If you don’t drink a lot of dark beverages (red wine, dark juices, coffee) or smoke, your results can last a year or more. Recent research has shown that even one year after bleaching, your teeth are less likely to be as yellow as they were previously. Most patients prefer a short course (several days) of at-home bleaching every 6-12 months to keep their smile vibrant.